Can you explain TYPE I & TYPE II hits to a nondoc

[Texass]

I've been reading the various posts here with growing facination. Unfortunately I guess I'm kinda thick. What is the differences between a TYPE I and a TYPE II "hit"? I remember discussing DCI and DCS in my classes, but I don't know if this is what is being referred to or not.

Thanks,

 

[sky50960]

Type I / cutaneous manifestations, minor joint pain, or pain only
Type II /includes severe cardiopulmonary and neurological Symtoms.
Type III / combination of AGE and DCS with neurologic symptoms.

Fa.

The doc's will come up with more

 

[Dr Deco]

Dear Texas:

The designation of Type I and II "decompression sickness" (DCS)is somewhat old. It is retained because it is a useful classification scheme (though not descriptive)-- and it is well known.

There is currently a tendency to simply describe the sign or symptom and end there. A judgment is avoided concerning severity, and everything is placed into "decompression illness" or DCI.

For example, skin manifestations (mottling) are being debated as to whether they are mild manifestation of decompression or they signal something else more sinister. There are opinions that skin mottling is a simple manifestation and further worry is not warranted. This is the opinion of the US Air Force researchers. That is the current opinion here at NASA.

Others believe that skin mottling is often seen in association with a patent foramen ovale (PFO). This cardiac defect (along with gas bubbles in the venous system) could also belie the fact that the central nervous system (brain and spinal cord) is also be embolized at the same time that you encounter skin manifestations. We, therefore, have a quandary. If Type I is mild DCS and Type II is severe DCS, where do skin lesions belong?

Another problem with this “DCS” classification scheme is that it calls for a diagnosis. Is it a gas phase in the spinal cord, or in a peripheral nerve, or is it an embolism? In the end, does it matter in the field? (Does it matter at the treatment facility? Recompression is used for all of them.)

“Decompression illness” (DCI) is a term that has been advanced that will eliminate ”decompression sickness” (DCS) (gas bubbles formed in one location and remaining there) from embolism (gas bubbles formed in one location and migrating to another). Even among specialists, these terms are used almost interchangeably. It is considered bad form to use both terms in the same written article, however. They are not that interchangeable.

Dr Deco

 

[Texass]

I just wanted to confirm I was on the same page, albeit somewhat further back.

 

[DSATTecFreak]

Hi Guys,

AFAIK, DCS terminology goes like this

DCS type 1 would mean pain only, skin rash

DCS type 2 Central Nervous System involvement that pretty much covers all symptoms including pain!

DCS type 3 vestibular involvement

DCS type 4 Osteo Necrosis (bone degeneration) due to repetitive insufficient decompressions such as using bubble models (my instructor tells me), but this can take some years to manifest.

DTF

Deco Stop=time spent eliminating mostly inert gas

 

[DepartureDiver]

DCS type 4 Osteo Necrosis (bone degeneration) due to repetitive insufficient decompressions such as using bubble models (my instructor tells me)

I want to make sure we are on the same page. Bubble models do not create bubbles, they simply account for bubbles that have always been there and ignored. Bubble models generate deeper stops, etc. and if anything would help reduce dysbaric osteonecrosis. The only debate would be how long to decompress (which your instructor could have been referring to) since some Tech divers pride themselves in how fast they can decompress. But bubble models are your friend that would help and not be the cause of this problem.

 

[BigJetDriver]

Dear Texas:

The designation of Type I and II "decompression sickness" (DCS)is somewhat old. It is retained because it is a useful classification scheme (though not descriptive)-- and it is well known.

There is currently a tendency to simply describe the sign or symptom and end there. A judgment is avoided concerning severity, and everything is placed into "decompression illness" or DCI.

For example, skin manifestations (mottling) are being debated as to whether they are mild manifestation of decompression or they signal something else more sinister. There are opinions that skin mottling is a simple manifestation and further worry is not warranted. This is the opinion of the US Air Force researchers. That is the current opinion here at NASA.

Others believe that skin mottling is often seen in association with a patent foramen ovale (PFO). This cardiac defect (along with gas bubbles in the venous system) could also belie the fact that the central nervous system (brain and spinal cord) is also be embolized at the same time that you encounter skin manifestations. We, therefore, have a quandary. If Type I is mild DCS and Type II is severe DCS, where do skin lesions belong?

Another problem with this “DCS” classification scheme is that it calls for a diagnosis. Is it a gas phase in the spinal cord, or in a peripheral nerve, or is it an embolism? In the end, does it matter in the field? (Does it matter at the treatment facility? Recompression is used for all of them.)

“Decompression illness” (DCI) is a term that has been advanced that will eliminate ”decompression sickness” (DCS) (gas bubbles formed in one location and remaining there) from embolism (gas bubbles formed in one location and migrating to another). Even among specialists, these terms are used almost interchangeably. It is considered bad form to use both terms in the same written article, however. They are not that interchangeable.

Dr Deco

THANKS, MIKE. ON TARGET AS ALWAYS!

ROB

 

[mikerault]

Ok. so after a few dives I developed a series of red dots on my upper chest. They didn't itch or inflame and eventually they "scratched" off leaving no marks I can see. These were only about the size of a small goose bump. No other symptoms. Is this stage 1 or just a reaction to something? These dives were all 80 feet or less, we did the deepest dives first and a safty stop, exceeded no chart or computer limits. There was some mild joint pain in the elbows but I attribute that to helping the divemaster carry the tanks to the boat and back (hey I am a computer nerd, not a weight lifter!). The pain went away in a short time. No other joints hurt. This was after about 18 dives in a space of less than 4 weeks.

Mike

 

[triton94949]

...“Decompression illness” (DCI) is a term that has been advanced that will eliminate ”decompression sickness” (DCS) (gas bubbles formed in one location and remaining there) from embolism (gas bubbles formed in one location and migrating to another). Even among specialists, these terms are used almost interchangeably. It is considered bad form to use both terms in the same written article, however. They are not that interchangeable.

Dr Deco

Doc,

Gary Gentile, in his tech book, suggests an even more modern coinage of the terminology: DeCompression Injury.

He points out that the condition results from an action, such as an accident, rather than from a disease, such as would normally be termed "illness."

I suppose the suggestion has not become widely known as of yet. But it does seem to have tremendous merit.

 

[ScubaDadMiami]

Doc,

Gary Gentile, in his tech book, suggests an even more modern coinage of the terminology: DeCompression Injury.

He points out that the condition results from an action, such as an accident, rather than from a disease, such as would normally be termed "illness."

I suppose the suggestion has not become widely known as of yet. But it does seem to have tremendous merit.

Which book is that?